c

页面

2015年2月23日星期一

Should She be Like This?

"Should she be like this after only a year and being on medication?" asked John.

"Well, there are probably a few things going on here. Her illness probably started long before she was diagnosed last January. She and you and your family and her colleagues probably disregarded any numbers of symptoms as fluke, or normal, or chalked up to stress, not enough sleep, too much to drink, and on and on. This could've gone on easily for a year or tow or longer.

"And she's incredibly bright. If the average person has, say for simplicity, ten synapses that lead to a piece of information, Alice could easily have fifty. When the average person loses those ten synapses, that piece of information is inaccessible to them, forgotten. But Alice can loose ten and still have forty other ways of getting to the target. So her anatomical losses aren't as profoundly and functionally at first."

"But by now, she's lost a lot more than ten," said John.

"Yes, I'm afraid she has. Her recent memory is now falling in the bottom three percent of those able to complete the tests, her language processing has degraded considerably, she's losing self-awareness, all as we'd unfortunately expect to see.

"But she's also incredibly resourceful. She used a number of invention strategies today to answer questions correctly that she couldn't actually remember correctly."

"But there were alot of questions that she couldn't answer correctly regardless," said John.

"Yes, that's true."

"It's just getting so much worse, so quickly. Can we up the dosage of either the Aricept or the Namenda?" asked John.

"No, she's at the maximum dosage already for both. Unfortunately, this is a progressive, degenerative disease with no cure. It gets worse, despite any medication we have right now."

"And it's clear she's either getting the placebo or this Amylix drug doesn't work," said John.

Dr. Davis paused as if considering whether to agree or disagree with this.

"I know you're discouraged. But I've often seen unexpected period of plateau, where it seems to stall, and this can last for some time."

Alice closed her eyes and pictured herself standing solidly in the middle of a plateau. A beautiful mesa. She could see it, and it was worth hoping for. Could John see it? Could he still hope for her, or had he already given up? Or worse, did he actually hope for her rapid decline, so he could take her, vacant and complaisant, to New York in the fall? Would he choose to stand with her on the plateau or push her down the hill?